Stroke-Heart Syndrome: Does Sex Matter?

Background Cardiovascular complications after acute ischemic stroke (AIS) can be related to chronic/comorbid cardiac conditions or acute disruption of the brain-heart autonomic axis (stroke-heart syndrome). Women are known to be more vulnerable to certain stress-induced cardiac complications, such a...

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Bibliographic Details
Published in:Journal of the American Heart Association 2023-11, Vol.12 (21), p.e029799-e029799
Main Authors: Rosso, Michela, Ramaswamy, Srinath, Kvantaliani, Nino, Mulatu, Yohannes, Little, Jessica N, Marczak, Izabela, Brahmaroutu, Ankita, Deo, Rajat, Lewey, Jennifer, Messé, Steven R, Cucchiara, Brett L, Levine, Steven R, Kasner, Scott E
Format: Article
Language:English
Subjects:
Acute Coronary Syndrome
Biomarkers
cardiac complications
Coronary Artery Disease
Female
Heart Diseases
Humans
Ischemic Stroke
Male
mortality
Myocardial Infarction
Original Research
Retrospective Studies
Stroke
stroke‐heart syndrome
troponin
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Summary:Background Cardiovascular complications after acute ischemic stroke (AIS) can be related to chronic/comorbid cardiac conditions or acute disruption of the brain-heart autonomic axis (stroke-heart syndrome). Women are known to be more vulnerable to certain stress-induced cardiac complications, such as Takotsubo cardiomyopathy. We investigated sex differences in cardiac troponin (cTn) elevation, cardiac events, and outcomes after AIS. Methods and Results We retrospectively analyzed consecutive patients with AIS from 5 stroke centers. Patients with AIS with elevated baseline cTn and at least 2 cTn measurements were included, while patients with acute comorbid conditions that could impact cTn levels were excluded. Poststroke acute myocardial injury was defined as the presence of a dynamic cTn pattern (rise/fall >20% in serial measurements) in the absence of acute atherosclerotic coronary disease (type 1 myocardial infarction) or cardiac death (type 3 myocardial infarction). From a total cohort of 3789 patients with AIS, 300 patients were included in the study: 160 were women (53%). Women were older, had a lower burden of cardiovascular risk factors, and more frequently had cardioembolic stroke and right insula involvement ( values all
ISSN:2047-9980
2047-9980
DOI:10.1161/JAHA.123.029799